The prevalence of pediatric nosocomial fungal infections

Abstract

Background and objectives: The aim of this study was to identify the incidence of nosocomial fungal infections in pediatric patients and evaluate the etiological agents, risk factors, and sites of infections.

Materials and methods: Clinical samples were cultured to assess fungal colonization. When fungal nosocomial infections were suspected according to the European Organization for Research and Treatment of Cancer criteria, clinical samples were evaluated using direct microscopic, culture, and molecular methods. Susceptibility patterns of the isolates were evaluated according to the Clinical and Laboratory Standard Institute.

Results: From the 1450 patients, 190 cases (5.5%) were evaluated for nosocomial fungal infections. Candida colonization was observed in 35 (18.4%) patients. The rate of nosocomial fungal infections in pediatrics was 2.69% (12 cases with proven and 27 cases with probable infections, 39/1450). Bloodstream and lungs were the frequent infected sites of patients' body. Aspergillus species (Aspergillus flavus and Aspergillus fumigatus), Candida species (Candida albicans, Candida parapsilosis, Candida glabrata) and Mucorales were the etiologic agents of infections. Caspofungin and luliconazole were effective antifungal agents for isolated fungi. The rate of mortality in infected patients suffering from proven and probable infections was 15.4% (6/39 cases).

Conclusion: Due to the high mortality rates of fungal infections in pediatrics, it is essential to identify modifiable risk factors, and implement control measures along with early detection techniques in pediatric populations.

Keywords: Aspergillus; Candida; Colonization; Fungal drug resistance; Fungal infection; Pediatrics.

Fig. 1.

Information about patients admitted in different pediatric wards during study period